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The Ministry of Health in Gaza said on Tuesday that the Israeli occupation authorities deliberately prevented passage of nitrous gas, which is used as an anesthetic, for the third time in one month.

Ashraf al-Qidra, spokesman of the Ministry of Health in Gaza, said that during January 2017, the Israeli occupation forces prevented entry of nitrous gas into the Gaza Strip three times in a row infringing Gazan patients’ rights of receiving decent treatment, and this comes in conjunction with an Israeli escalation against the Strip.

According to al-Quds Press news agency, al-Qidra stated that the hospitals of the Gaza Strip need more than 4000 kg of nitrous gas with a rate of over than 200 surgeries a day, which requires a continuous availability of this gas especially after the latest Israeli escalation on the Gaza Strip.

Al-Qidra pointed out that the quantities entering Gaza are restricted according to specific policies set by Israel to ensure that the Ministry of Health doesn’t have additional supplies.

He warned that the lack of nitrous gas will affect the health status of patients who have to undergo surgeries on a daily basis, calling at the same time on the international institutions to immediately act to allow entry of the anesthetic gas to the hospitals of Gaza.

Israel has been imposing a blockade on the Gaza Strip for ten years ago and closed all borders and crossings linking Gaza with the outside world while opening them partially and in exceptional cases for the passage of goods and people.

The Gaza Strip does not have adequate resources for medical treatment, but Israel prevents patients from leaving.

Around 1,500 people are diagnosed with cancer in Gaza every year

Gaza City – “I’m like a bird in a cage,” Hind Shaheen told Al Jazeera as she lay in bed at Gaza City’s Al-Rantisi hospital, surrounded by family members. “Outside of my cage I can see water and food, but I can’t reach it. This is my condition right now.”

Shahin, who suffers from breast cancer, says that her condition has been deteriorating ever since she was denied exit from Gaza for treatment.

The Gaza Strip does not have adequate resources to provide her with appropriate treatment, yet she cannot leave, as Israeli authorities at the Erez border crossing, known as Beit Hanoon to Palestinians, rejected her permit three times in a row without explanation.

The condition of Hind Shahin, a breast cancer patient, has been deteriorating ever since she was denied exit from Gaza for treatment

Gaza has been under an Israeli and Egyptian blockade since 2007. The Erez checkpoint is the main exit for two million residents of Gaza, connecting them to medical care in Israel and the occupied West Bank.

Her struggle is familiar to thousands of patients in Gaza, where around 1,500 people are diagnosed with cancer each year. Chemotherapy drugs are not always available, nor are radiotherapy, molecular therapy, PET scans or isotope scans.

Gisha, the Legal Centre for Freedom of Movement, says that patients in Gaza have increasingly been blocked from leaving due to “security” precautions. Others are interrogated at the crossing or forced to wait lengthy periods of time for a response.

According to the World Health Organisation (WHO), approval rates for exit permits from Gaza dropped as low as 44 percent in October 2016, compared with 82 percent in 2014 and 93 percent in 2012.

“[The patients] ask for permission again and again, but the response from Israeli authorities is always that it’s under [assessment],” Awad Aeshan, a radiation oncologist at Al-Shifa hospital, told Al Jazeera. “They continue to assess for one year, two years until the patient dies. So this is a massacre of our cancer patients. They have placed a siege on the Gaza Strip and they don’t permit our cancer patients to leave for treatment.”

My husband and children cried a lot when I was diagnosed. I think about the future now and how to secure my children before I die.

Seham Tatari, leukaemia patient

An Israeli spokesperson from the Coordination of Government Activities in the Territories (COGAT) unit disputed this claim, citing an increase in the number of patients crossing Erez in recent years, from 22,380 in 2013 to 30,768 in 2016. However, the numbers do not take into account Gaza’s steep population growth.

Breast cancer is one of the most treatable forms of cancer, yet five-year survival rates in Gaza are as low as 30 percent, compared with around 85 percent in England and 86 percent in Israel.

Radiotherapy is vital for breast conservation, but as it is unavailable in Gaza, a high number of women undergo a full mastectomy and lymph node clearance, which would normally be unnecessary.

When Philippa Whitford, a Scottish breast cancer surgeon, asked a patient support group in Gaza’s Al-Bureij refugee camp how many had undergone mastectomy, all of them raised their hands. “Radio isotopes used in bone scans or for guided biopsy of axillary lymph nodes are forbidden entry into Gaza despite having no potentially dangerous application,” Whitford wrote in a column.

Patients are also often diagnosed with cancer at later stages due to limited services; Gaza only has two functioning mammograms.

Aeshan says that he sees between 50 and 60 patients a day, and only half of them can receive their chemotherapy treatment in Gaza. Around two-thirds of cancer patients require radiotherapy treatment, and hundreds are referred for outside treatment in occupied East Jerusalem every month.

Due to the decade-long blockade, surgical skills in Gaza have been frozen in time. According to a 2010 report by the WHO, there are no specialist surgeons to treat oesophageal, pancreatic or lung cancer.

Seham Tatari, 52, who is battling chronic lymphoid leukaemia, had been leaving Gaza every 20 days for chemotherapy treatment in the occupied West Bank. She had just four more sessions to go when she received a text message last October regarding her permit. It read: “Seham Tatari – Banned.”

“I’ve been going every 20 days for the past three years. Why am I banned now? It doesn’t make any sense,” Tatari told a cancer patients’ support group in Gaza City.

Chemotherapy treatment is a painful process and if it is interrupted, the patient has to start over from the beginning.

“My husband and children cried a lot when I was diagnosed. I think about the future now and how to secure my children before I die. We are dying slowly in Gaza,” Tatari said. “My cancer was controllable [before they banned me from leaving], but now it can spread. My whole body is in pain because I haven’t been taking any medications; they’re not available all the time in Gaza.”

Before the start of the blockade in 2007, Gaza was the centre for medications, said Talha Ahmad, a chemotherapy pharmacist. He now describes his workplace at the hospital as a war zone.

Talha Ahmad, a chemotherapy pharmacist, points to a shortage of medications in Gaza

“I’m fighting everywhere, every day to have the medications required for my patients,” Ahmad told Al Jazeera.

“We have a big shortage in basic medications. I’m not talking about new generations of chemotherapy medications; I’m talking about old medications, used 20 years ago in the world. We have a big shortage of them here.”

In August 2016, 17 percent of cancer drugs were at zero stock – less than one month’s supply on shelves – according to Medical Aid for Palestinians.

“I try to tell [my patients], ‘Your medication is not available,’ as gently as possible. It’s as if you’re telling them, ‘I will kill you slowly because your medication is not available,'” Ahmad said.

“I try to make adaptations to at least give them hope. I say, ‘It’s OK, it will be here next week. This delay will not harm you.’ But I believe these patients have the right to have their medication [immediately].”

There have also been reports of extortion of patients as they attempt to reach hospitals a short distance away for life-saving treatment.

Last July, 19-year-old Yousef Younis received a phone call from the Israeli security service after applying for a permit to treat his leukaemia in Jerusalem. They told him that he could cross if he collaborated with them. He refused, and consequently, his permit was denied. His health quickly deteriorated, and he died the next month.

Israel as an occupying force is obligated under international humanitarian law to ensure the Palestinian population’s access to medical treatment and to maintain its medical facilities, hospitals and services in the occupied territories.

Gisha found that whenever they challenged a denied permit legally or through media work, Israeli authorities would reverse their decision and grant a travel permit. “This calls into question the arbitrary and slack decision-making process for assigning a security block in the first place,” Gisha noted.

Back at Al-Rantisi Hospital, Muhammad Qahman, 67, waits for his appointment. Three days after his brother died from lung cancer, Qahman was diagnosed with the same illness. The cancer has now spread to his brain.

The last time he went through Erez, Qahman was in a bad state and waited at the crossing for two hours with an oxygen mask on, his family said. They are worried about his deteriorating condition and the expensive medications available only in Israel.

Palestinian Ministry of Health official statistics revealed that the rate of cancer patients in Palestine reached 83.8 per one 100 thousand persons, 83.9 cases per 100 thousand persons in Gaza and 83.8 cases per 100 thousand persons in the West Bank.

The Ministry of Health said in a statistical report, on World Cancer Day Feb 4, that 52.5% of the new cancer cases are females and 47.4% are males.

In 2015, 3,927 new cancer cases were reported in Palestine, 2,400 of which were in the West Bank and 1,527 were in the Gaza Strip, the report added.

The Ministry pointed out that 34.4% of the cancer cases occurred in the age group of above than 65 years, which equals 2.9% of the population. However, 59.8% of the cancer cases occurred in the age group of 15-64 and 6.8% of the cancer cases occurred in the age group of less than 15.

Breast cancer ranks first

Breast cancer ranks first since it constitutes 17.8% of all cancer cases, according to Dr. Jawad al-Bitar, the director of the ministry’s Health Information Center.

“Breast cancer also came first for cancers that affect women in Palestine, which reached 33.7% with a rate of 33.1 new cases per 100 thousand females in Palestine annually,” he added.

Colon Cancer comes second regarding cancer cases with the rate of 9.4%. Lung cancer comes third with the rate of 8.7%, but it its ranked first for cancers that affect males, which reached 14.3% and 12.3% new cases per 100 thousand males in Palestine annually, he pointed out.

The data of the National Cancer Registry in Palestine, a section of the Health Information Center, shows that the five cancers, breasts, lung, colon, leukemia and brain, constitute a rate of 58.6% of the cancer cases leading to death among Palestinians, more than half cancer deaths in Palestine.
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Leukemia is the most common among children with a rate of 30.2% followed by brain cancer with a rate of 18.5%, he continued.

Al-Bitar pointed out that in the past five years cancer was the second leading cause of death in Palestine after cardiovascular diseases.

Cancer caused 13.8% of deaths in Palestine

The Ministry of Health said that 13.8% of Palestinians die because of cancer, 13.2% of which are in Gaza and 14.1% are in the West Bank.

In 2015, 1,746 Palestinians died because of cancer, 656 were in Gaza and 1,090 were in the West Bank.

Meanwhile, lung cancer ranks first in deaths caused by cancer in Palestine, 17.5%, followed by colon cancer, 12.4%. Breast cancer reached a rate of 11.2% of deaths caused by cancer in Palestine followed by brain cancer, 11.2%, and leukemia, 8.6%, the Ministry of Health said.

For males who died because of cancer, lung cancer was the main cause with a rate of 27%, 27.5% of which are in Gaza and 26.7% are in the West Bank, followed by Colon cancer with a rate of 11.2%. For females, however, breast cancer ranks first regarding deaths caused by cancer with a rate of 23.2%, 22.8% in Gaza and 23.3% in the West Bank, followed by colon cancer with a rate of 13.7%, the Ministry added.

Number one leading cause of death worldwide

The fourth of February marks World Cancer Day in which the Palestinian Ministry of health joins the International Union against Cancer and the World Health Organization to promote ways to ease the burden of cancer as efforts are focused on the importance of prevention of cancer, detection of early signs of cancer, and improving the life quality of patients.

The campaign in 2017 aims at taking a positive attitude through the publication of hopeful messages about fighting cancer with a motto of “We can. I can,” which means we can fight cancer by making the right choices.

Cancer is now ranked as the first leading cause of death worldwide in which most cases occur due to high body mass and obesity rate, lack of eating fruits and vegetables, lack of physical activity, and smoking, as well as other factors.

Efforts to develop current services

According to the report, the Ministry of Health is exerting enormous efforts to develop its services and capabilities in this area by spending millions of dollars of its budget to treat cancer patients.

In this regard, Health Minister, Jawad Awad, said that he is working tirelessly to establish Martyr Khaled Hassan Medical Center for Cancer and bone marrow to resettle many therapeutic services in order to ease and end the suffering of many Palestinian families.

The Ministry of Health carried out, with partners from health providers, a national strategy for prevention and control of cancer, which seeks to reduce cancer cases among Palestinian citizens through preventive measures and programs for the early detection in addition to providing appropriate care for patients, he added.

Also, the Ministry of Health has adopted a free national survey of breast cancer among Palestinian women. For this purpose, the Ministry provided in all provinces mammography devices, he continued.

Cancer patients are being diagnosed and treated in the hospitals of the Ministry of Health particularly at Al-Hussein Hospital in Beit Jala, which is considered the main center in the West Bank. The hospital’s section for treating children tumors named “Huda al-Masri”, was designed according to international specifications, he added.

For his part, Regional Director of the Saudi National Campaign Dr. Badr bin Abdulrahman Al-Samhan said that the Saudi specialist clinics provide health care according to the medical and psychological needs of the Syrian refugees.

BRUSSELS, (PIC)– The Assembly of Palestinian doctors in Europe (PalMed) warned on Wednesday of the serious upshots of an Israeli bill to force-feed Palestinian hunger-striking detainees, saying the law amounts to a legitimization of murder. PalMed Chairman, Dr. Mondher Rajab, slammed the Israeli force-feeding law, dubbing it a barefaced incitement to the murder of Palestinian hunger-strikers in Israeli jails and a call to torture. PalMed charged that the force-feeding law flagrantly violates the World Medical Association’s Declaration of Malta 1991 which states, “forcible feeding is never ethically acceptable.” The Assembly also said that feeding induced by threats or coercion is inhumane and that it violates the 1975 World Medical Association Declaration of Tokyo which explicitly states that force-feeding is a crime and a form of torture. The statement also pointed to the serious health complications of this cruel measure on the prisoners’ health; as it is very painful and it may lead to death as what actually happened with a number of Palestinian prisoners. In earlier statements, the Assembly called on international health institutions, and human rights organizations, including the United Nations, the Red Cross, and Doctors Without Borders, to immediately condemn the Israeli decision and pressure the occupation government to cancel it, improve the prisoners’ detention conditions, and allow doctors’ visits to check on the prisoners’ health status. The Supreme Court of Israel on Sunday ruled to allow for the force-feeding of Palestinian prisoners who are on hunger strike after a panel of judges rejected a petition which called to cancel the force-feeding bill. The Knesset voted the “force-feed” bill into law in July 2015, with 46 MKs voting in favor and 40 voting against. The ruling upheld a 2015 law to allow force-feeding as constitutional, despite a range of objections by human rights organizations. Hunger strikes have become a high profile means by which Palestinians can peacefully resist their capture and arbitrary detainment by Israeli authorities. There are currently three Palestinians – detained without charge – in Israeli prisons who are on hunger strike one of whom, Al-Qadi, 25, slipped into a coma last week.

NABLUS (Ma’an) — Ahmad Dawabsha, the five-year-old sole survivor of an arson attack in the village of Duma in the occupied West Bank district of Nablus last year, was taken to Israel’s Tel Hashomer hospital Wednesday night after his health deteriorated.Naser Dawabsha, a member of the family, told Ma’an that the “child’s health has severely deteriorated,” adding that Ahmad has suffered from “constant vomiting and an increase in body temperature.”Naser said that medical tests were done on Ahmad and he would remain in the hospital until his health condition stabilized.Ahmad was officially released from the hospital last month, returning for weekly checkups and additional surgeries expected over the coming months, most of them plastic surgeries to help reconstruct parts of his body and face which were severely burned in the attack.The young boy was severely injured in the high-profile attack which took place in the town of Duma in the Nablus district in July 2015, and has undergone a series of complex surgeries since.Two Israelis were indicted for murder for the arson in January, five months after suspects belonging to a Jewish terror organization set the home of the Dawabsha family ablaze, burning 18-month-old Ali to death.The infant’s parents, Riham and Saad, later died from severe burns, leaving then four-year-old Ahmad Dawabsha the only surviving member of the family.According to rights group Yesh Din, over 85 percent of investigations into violence committed by Israeli settlers against Palestinians are closed without indictments and only 1.9 percent of complaints submitted by Palestinians against Israeli settler attacks result in a conviction.Attacks by settlers are often carried out under the armed protection of Israeli forces, who rarely make efforts to protect Palestinians from such attacks.An upwards of 500,000 Israelis live in Jewish-only settlements across occupied East Jerusalem and the West Bank in violation of international law, with recent announcements of settlement expansion provoking condemnation from the international community.According to the United Nations Office for the Coordination of Humanitarian Affairs, there were a total of 221 reported settler attacks against Palestinians and their properties in the West Bank and occupied East Jerusalem in 2015.

The 2014 attacks on Gaza killed more than 2,000 Palestinians and injured 11,000, leaving approximately 900 with permanent disabilities. As our latest infographic shows, needing to access care after the conflict struggle to do so due to the nine-year blockade and closure of Gaza, and the damage caused to Gaza’s health sector in 2014.

During the attacks 17 hospitals, 56 primary health clinics, and 45 ambulances were damaged or destroyed, and 16 medical workers lost their lives while on duty.Last year, we partnered with the Al Mezan Center for Human Rights in Gaza and Lawyers for Palestinian Human Rights to highlight some of these cases in our ‘No More Impunity: Gaza’s Health Sector Under Attack‘ report, and called for thorough, independent investigation into potential violations of international humanitarian law. This year, we have revisited the victims and survivors of these attacks, to ask how the lack of accountability or access to justice has affected their lives.

Last month, the UN Office for the Coordination of Humanitarian Affairs (UN OCHA) highlighted the continuing challenges for Gaza’s health system, including shortages of medicines and long waiting lists for surgeries caused by operating room personnel shortages. Their report also found that progress made in rehabilitating damaged health infrastructure. All of the damaged facilities have been or are in the process of being rehabilitated, though the Al Wafa Hospital – featured in our report – has not been rebuilt.

This week, writing in The National about his team’s struggle to provide adequate care to patients in their temporary site, Al Wafa Hospital Director Dr Basman Alashi said:

“Though we hope to rebuild, we cannot do so in the same place for fear of being attacked again. Our only hope is to rebuild on a new site, but even this cannot guarantee our safety in Gaza. The prospect of new attacks hangs over us.”

With the blockade still in place, patients continue to struggle to access adequate health services inside Gaza, and are often prevented or delayed when seeking to travel abroad for urgent care. Though progress has been made in rebuilding after the 2014 attacks, Al Wafa remains in ruins.

Medical Aid for Palestinians has joined with 42 other aid and faith organisations to call for an end to the blockade and closure of Gaza.

GAZA, (PIC)– Medical staff of Martyr Mohammed al-Dura hospital for children in Gaza staged a sit-in at hospital and asked the international community to protect health care rights of Palestinian children. The Director of the hospital Dr. Jamil Salman delivered a speech during the sit-in which was conducted in order to mark the second anniversary of the Israeli attack on the hospital. He said the children of Gaza were not spared in the Israeli aggression even while in the laps of their mothers, at school, play yards or even at hospital. Israeli forces bombed the hospital in the aggression of 2014 leading to the martyrdom of child Ibrahim al-Sheikh Omar while he was receiving treatment in the hospital’s intensive care unit, he said, adding that many of the hospital’s sections were damaged as well.

Cairo: At least 3,675 people died in Egypt in 2015 as a result of injuries caused by road accidents, burns, poisoning and other reasons that are considered largely preventable.

Statistics provided by the Central Administration for Critical and Urgent Care, although not comprehensive, showed that violence-related accidents like: fights, fire shooting, explosion of strange bodies and shells account for around 21 percent of the total 7,053 accidents cited last year.

According to the World Health Organization (WHO,) injuries and violence are among the most prominent public health problems globally, and a leading cause of mortality; many of the non-fatal injuries result in health consequences and life-long disabilities.

A huge fire erupted May 9 at a Cairo hotel and extended to four other buildings in El-Roweay district, in Ataba, leaving dozens

On the top of a list containing 29 types of accidents in Egypt, traffic crashes account for 53.3 percent of the total accidents. Around 3 percent of the road injuries suffer disability, Dr. Khaled el-Khateeb, head of Central Administration for Critical and Urgent Care said in an interview with The Cairo Post.

Cairo has witnessed the highest number of accidents amounting to 850, while the restive area of North Sinai saw 279 last year, according to the administration’s report that did not detail types of accidents in each governorate.

The emergency sector in Egypt has faced many challenges since 2011 Revolution, said El-Khateeb, adding that doctors dealt with new kinds of violence-related injuries in huge numbers, “it was like an exam to us at this time.”

Now, Sinai is facing a “war” that results in many fatal injuries, according to El-Khateeb. “As trauma doctors are afraid to be assigned there, we mostly depend on Sinai-based doctors, and volunteering rapid deployment teams.”

“Egypt should pay utmost attention to trauma care and services,” said Dr. El-Khateeb, as he cites citizens’ complaints over lack of beds at intensive care (ICU) and burns treatment units.

The administration, which is part of the health ministry, was officially launched in 2010, where it was tasked with operating emergency and ambulance departments only. Other departments like burns, poisons and pre-term birth care were not working efficiently or even been monitored then.

“That’s why we chose the toughest task, which is bringing all these departments to work under the administration,” continued El-Khateeb.

“Talking about trauma care mainly means swift ambulance service, and good emergency care,” said El-Khateeb, adding that the administration in the beginning focused on assessing the status-quo of the emergency departments after former health ministers raised efficiency of the ambulance sector with fully equipped vehicles.

Police open the way for ambulances carrying the bodies of passengers of a Russian airliner which crashed in Sinai, into a morgue October 31, 2015

First of all, he said that the emergency sector suffers a big problem, which is lack of staff; he cited students’ reluctance to register at medicine faculties, attributing the reason to low salaries and incentives allocated to trauma doctors.

Egypt has currently around 10,300 intensive care beds in both public and private hospitals; the figure is “very low” compared to other countries, said El-Khateeb.

“Egypt’s rate is equal to one bed for each 9,000 citizens; in some neighboring states, it is one bed for 7,000 citizens, while in the U.S., the rate is one bed for each 5,000 citizens,” he added.

According to El-Khateeb, at least 3,000 additional intensive care beds are needed so that the country can meet people’s need for urgent services, “but both public and private hospitals should share responsibility to provide them.”

The head of the administration added that “around 1,300 incubators are also needed at pre-term birth care units.”

“We do not ignore the fact that there are deficiencies in the emergency care units; however, we have short and long term plans to eliminate such deficiencies because maintaining people’s health is our mission,” El-Khateeb added.

Egypt’s to-do-list for injury prevention

According to a 2014 WHO report on injury prevention, more than 5 million people die each year as a result of injuries, making 9% of the world’s deaths, nearly 1.7 times the number of fatalities that result from HIV/AIDS, tuberculosis and malaria combined.

Illustration shows deaths as a result of injury per year exceeding rate of infection with serious diseases

The report said that low and middle income countries have higher rates of fatal and non-fatal injuries than wealthier ones; however, it stressed that successful adoption of preventable measures has significantly reduced injuries in some countries.

El-Khateeb explained to The Cairo Post that a plan to prevent injuries has been designed by the administration, in cooperation with WHO, based on two axes: therapeutic and preventive measures.

The therapeutic care measures includes: raising efficiency of hospitals by classifying them into three categories of A, B and C, and providing them with emergency devices according to their proximity to highways and the number of trauma patients checking in.

The Ministry of Health has cooperated with WHO in conducting training sessions to 300-400 doctors and 200-300 nurses in emergency, burns and intensive care services, El-Khateeb added.

As part of the ministry’s short-term development plan for emergency departments, El-Khateeb mentioned that 300 new intensive care beds, 500 incubators and 28 burns treatment units will be added by the financial year 2016/2017. The total cost of the plan for the same FY is around 150 million EGP.

An awareness campaign, funded by WHO, is among preventive measures, with TV ads and printed flyers aiming at raising people’s and students’ awareness against all types of injuries.

Road injuries: pre-hospital care

Despite road accidents being on the top of Egypt’s agenda with new established roads, renewed bridges and drug screening carried out to drivers, annual death toll as a result of traffic injuries is still on the rise.

In 2015, Egypt’s road accidents recorded an increase, reaching 14,548 resulting in 6,203 deaths, 19,325 injured and 19,116 damaged vehicles, according to a latest report by the Central Agency for Public Mobilization and Statistics (CAPMAS.)

Bus accident

By 2030, road traffic injuries are predicted to become the 7th leading cause of death, according to WHO report.

“Unfortunately, victims of traffic injuries are mostly youth,” El-Khateeb said, adding that one of the main long-term projects he seeks to adopt is establishing trauma centers on highways.

He explained “instead of waiting until the injured is transferred to an internal hospital inside a governorate in order to receive the necessary care, which would cost him his life, trauma centers will be built to provide urgent pre-hospital care to stabilize the patient’s condition.”

Egypt is among 10 states enrolled in the UN Decade of Action program for road safety that aims to halve the rate of traffic deaths by 2020.